Buscar en
Gastroenterología y Hepatología
Toda la web
Inicio Gastroenterología y Hepatología Candidiasis sistémica y tratamiento con infliximab
Información de la revista
Vol. 27. Núm. 6.
Páginas 365-367 (Enero 2004)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 27. Núm. 6.
Páginas 365-367 (Enero 2004)
Acceso a texto completo
Candidiasis sistémica y tratamiento con infliximab
Systemic candidiasis and infliximab therapy
Visitas
4828
A. Belda, J. Hinojosa
Autor para correspondencia
hinojosa_joa@gva.es

Correspondencia: Dr. J. Hinojosa. Unidad de Aparato Digestivo. Servicio de Medicina Interna. Avda. Ramón i Cajal, s/n. 46520 Sagunto. Valencia. España.
, B. Serra, L. García, C. Merino, A. Belda, J.R. Molés
Unidad de Aparato Digestivo. Servicio de Medicina Interna. Hospital de Sagunto. Sagunto. Valencia. España
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Resumen

El uso del infliximab en pacientes con enfermedad de Crohn luminal o fistulizante refractaria al tratamiento médico (esteroides e inmunomoduladores) está cada vez más extendido. Aunque la incidencia de infecciones graves en los enfermos tratados con infliximab no es superior a la de los controles, se han descrito de forma anecdótica infecciones fúngicas sistémicas en pacientes en tratamiento con este anticuerpo. Aportamos un caso de candidiasis sistémica en una paciente con enfermedad de Crohn refractaria a la que se trató con infliximab asociado a su tratamiento con corticoides y azatioprina, y comentamos el papel que el infliximab pudo tener en el desarrollo de esta complicación.

The use of infliximab in patients with luminal or fistulizing Crohn's disease refractory to medical treatment (steroids and immunomodulatory drugs) is increasingly widespread. Although the incidence of serious infections in patients undergoing infliximab treatment is not higher than that of controls, systemic fungal infections in patients treated with this antibody have been anecdotally described. We report a case of systemic candidiasis in a patient with refractory Crohn's disease who was treated with infliximab associated with corticosteroids and azathioprine and discuss the role that infliximab could have played in the development of this complication.

El Texto completo está disponible en PDF
Bibliografía
[1.]
S. Van Deventer.
Tumour necrosis factor and Crohn's disease.
Gut, 40 (1997), pp. 443-448
[2.]
S.R. Targan, S.B. Hanauer, S. Van Deventer, et al.
A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease. Crohn's Disease cA2 Study Group.
N Engl J Med, 337 (1997), pp. 1029-1035
[3.]
D.H. Present, P. Rutgeerts, S. Targan, et al.
Infliximab for the treatment of fistulas in patients with Crohn's disease.
N Engl J Med, 340 (1999), pp. 1398-1405
[4.]
M. Regueiro, J. Valentine, S. Plevys, M.R. Fleisher, G.R. Lichtenstein.
Infliximab for treatment of pyoderma gangrenossum associated with inflammatory bowel disease.
Am J Gastroenterol, 98 (2003), pp. 1821-1826
[5.]
M.H. Tan, M. Gordon, O. Lebwhol, et al.
Improvement of pyoderma gangrenosum and psoriasis associated with Crohn's disease with anti-tumour necrosis factor alpha monoclonal antibody.
Arch Derm, 137 (2001), pp. 930-933
[6.]
R.J. Farrell, A.S. Samir, P.J. Lodhavia, et al.
Clinical experience with infliximab therapy in 100 patients with Crohn's disease.
Am J Gastroenterol, 95 (2000), pp. 3491-3497
[7.]
F. Baert, M. Noman, S. Vermeire, et al.
Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease.
N Engl J Med, 348 (2003), pp. 601-608
[8.]
CCOHTA Technology Report.
Infliximab for the treatment of Crohn's disease: a systematic review and cost-utility analysis.
CCOHTA Technology Report Issue 24, (March 2002),
[9.]
S.B. Hanauer, B.G. Feagan, G.R. Lichtenstein, et al.
Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial.
Lancet, 359 (2002), pp. 1541-1549
[10.]
J. Keane, S. Gershon, R. Wise, et al.
Tuberculosis associated with infliximab, a TNF-alpha neutralizing agent.
N Engl J Med, 345 (2001), pp. 1098-1104
[11.]
P.E. Lispsky, D.M.F.M. Van der Heijde, E.W. St Clair, et al.
Infliximab and methotrexate in the treatment of rheumatoid arthritis.
N Engl J Med, 343 (2000), pp. 1594-1602
[12.]
A. Warris, P. Bjorneklett.
Invasive pulmonary aspergillosis associated with infliximab therapy.
N Engl J Med, 344 (2001), pp. 1099-1100
[13.]
J.M. Van der Klooster, R.S. Bosman, H.M. Oudemans von Straaten, J.L. Van der Spoel, J.P. Wester, D.F. Zandstra.
Disseminated tuberculosis, pulmonary aspergillosis and cutaneous herpex simplex infection in a patient with infliximab and methotrexate.
Intensive Care Med, 29 (2003), pp. 2227-2329
[14.]
K.L. Wood, C.A. Hage, K.S. Knox, et al.
Histoplasmosis after treatment with anti-tumour necrosis factor alpha therapy.
Am J Respir Crit Care Med, 167 (2003), pp. 1279-1282
[15.]
P. Rutgeerts.
Review article: the limitations of corticosteroid therapy in Crohn's disease.
Aliment Pharmacol Ther, 15 (2001), pp. 1515-1525
[16.]
J. Brieland, D. Essig, C. Jackson, et al.
Comparison of pathogenesis and host immune responses to Candida glabrata and Candida albicans in systemically infected immunocompetent mice.
Infect Immun, 69 (2001), pp. 5046-5055
[17.]
S. Nikolaus, A. Raedler, T. Kühbacher, N. Sfikas, U. Fölsch, S. Schreiber.
Mechanism in failure of anti-TNF for Crohn's disease.
Lancet, 356 (2000), pp. 1475-1479
[18.]
D. Present, B.I. Korelitz, N. Wisch, et al.
Treatment of Crohn's disease with 6-mercaptopurine. A long-term, randomized, double blind study.
N Engl J Med, 302 (1980), pp. 981-987
[19.]
R. Modigliani.
Immunosuppresors for inflammatory bowel disease: how long is long enough?.
Inflamm Bowel Dis, 6 (2000), pp. 251-257
Copyright © 2004. Elsevier España, S.L.. Todos los derechos reservados
Opciones de artículo
Herramientas
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos